To the Editor:Pulmonary nodules are defined as localized opacities of up to 30 mm in diameter,surrounded by pulmonary parenchyma or located adjacent to the pleura.^([1])The ideal management for pulmonary nodules is to...To the Editor:Pulmonary nodules are defined as localized opacities of up to 30 mm in diameter,surrounded by pulmonary parenchyma or located adjacent to the pleura.^([1])The ideal management for pulmonary nodules is to diagnose and treat malignant nodules as early as possible and minimize radiation exposures,based on the general guidance.Clinical practice guidelines(CPGs)always provide efficient recommendations based on systematic reviews of high-quality evidence and reporting to optimize patient care.^([2])Accumulating evidence shows that adherence to the guidelines improves patient outcomes.^([3])However,the reporting quality of CPGs seems poor.^([4])Several instruments have been generated to evaluate the quality of CPGs.展开更多
To the Editor:Transthoracic needle aspiration(TTNA)and bronchoscopy have been the preferred methods for the sampling of pulmonary nodules suspected of lung cancer.However,despite having a higher diagnostic accuracy,TT...To the Editor:Transthoracic needle aspiration(TTNA)and bronchoscopy have been the preferred methods for the sampling of pulmonary nodules suspected of lung cancer.However,despite having a higher diagnostic accuracy,TTNA has been associated with a high rate of pneumothorax.Moreover,conventional bronchoscopy with a low rate of pneumothorax has exhibited a low diagnostic yield for peripheral pulmonary nodules,particularly for nodules<2 cm in size or those without a bronchus leading directly to them.Thus,Herth et al[1]developed a novel bronchoscopy technique called bronchoscopic transparenchymal nodule access(BTPNA)under the guidance of Archimedes Virtual Bronchoscopic Navigation(VBN)System for the purpose of accessing pulmonary nodules using a transparenchymal approach without relying on the airway to approach the lesion.Here,we systematically reviewed evidence regarding BTPNA to provide general guidance on the safe implementation and development of this novel approach.展开更多
文摘To the Editor:Pulmonary nodules are defined as localized opacities of up to 30 mm in diameter,surrounded by pulmonary parenchyma or located adjacent to the pleura.^([1])The ideal management for pulmonary nodules is to diagnose and treat malignant nodules as early as possible and minimize radiation exposures,based on the general guidance.Clinical practice guidelines(CPGs)always provide efficient recommendations based on systematic reviews of high-quality evidence and reporting to optimize patient care.^([2])Accumulating evidence shows that adherence to the guidelines improves patient outcomes.^([3])However,the reporting quality of CPGs seems poor.^([4])Several instruments have been generated to evaluate the quality of CPGs.
文摘To the Editor:Transthoracic needle aspiration(TTNA)and bronchoscopy have been the preferred methods for the sampling of pulmonary nodules suspected of lung cancer.However,despite having a higher diagnostic accuracy,TTNA has been associated with a high rate of pneumothorax.Moreover,conventional bronchoscopy with a low rate of pneumothorax has exhibited a low diagnostic yield for peripheral pulmonary nodules,particularly for nodules<2 cm in size or those without a bronchus leading directly to them.Thus,Herth et al[1]developed a novel bronchoscopy technique called bronchoscopic transparenchymal nodule access(BTPNA)under the guidance of Archimedes Virtual Bronchoscopic Navigation(VBN)System for the purpose of accessing pulmonary nodules using a transparenchymal approach without relying on the airway to approach the lesion.Here,we systematically reviewed evidence regarding BTPNA to provide general guidance on the safe implementation and development of this novel approach.
